Larisa Lofitskaya/Getty Images/iStockphotoAfter a Toronto District School Board survey revealed high levels of anxiety in teenagers, we asked online readers to submit their questions about anxiety in that age group to Dr. Alexa Bagnell in Halifax. Here are some of her answers.


What is normal anxiety for a teenager?

Worries, fears and anxiety are very common experiences for everyone. In fact, anxiety is important for our survival and success. Anxiety can help us with being safe (e.g., looking both ways before you cross the street) and preparing for a test or performance. Times of change such as changing schools, moving and divorce often have some period of anxiety that occurs with the change. Anxiety can cause you to feel sick at times, such as having headaches and stomachaches. It is also normal to be fearful or worried about something for a short period of time, like giving a talk, or being in an unfamiliar environment. About one in 10 children, teens and adults will have anxiety that interferes with their life and gets in the way of what they should be doing and causes a lot of distress. Anxiety is triggered in the brain, and is the body’s way of keeping track of important things and keeping a person safe and facing challenges.

Anxiety can often lead to behaviours such as looking for reassurance that things will be okay and nothing bad will happen (it makes you doubt your own realistic thinking and rely on someone else to manage your worries), creating patterns or routines to make things predictable and prevent bad things (such as bedtime routines or rituals) and avoidance of things that make you fearful or worried (such as going to a friend’s house for a sleepover). If a person is tired, upset, sad, stressed or hungry, the brain is more likely to worry or to feel anxious about something – and some people are more likely to worry because of their biology (e.g., genes). Some amount of anxiety and anxious behaviours is normal, and does not cause much distress or interfere with daily routine such as school, friends and family.

When should I start to worry?

If anxiety starts to take over a child and family’s life, it is no longer helpful and protective. Anxiety disorders are diagnosed when fears, worries or anxiety occur outside the range of normal expected responses, and are extreme and cause serious distress and get in the way of everyday activity (school, home, friends).

How should I think about dealing with it?

When anxiety does happen or your child is worried about something, first try to identify whether they are experiencing anxiety or worry. Is what they are worried about realistic, or is their anxiety making it bigger than it should be? Try to help them think like a detective and collect some evidence as to whether this is something they need to worry about. Make them feel they can ask for help and support when they are feeling anxious or worried – and if you are answering the same question over and over, it can help to identify this. Figure out what the next thing would be to help them with their concern. Too much reassurance can make the child dependent – the more they are coached to come up with their own answers and handle their anxiety, the more confident they will be. Try not to let anxiety make your child avoid things they usually do and should be doing (such as going to school). Avoiding situations makes anxiety worse in the long run. (For other suggestions and strategies in managing anxiety go to ).

Where should I turn for help

If you are feeling that anxiety is too much in control of your child’s life, and is causing distress and interfering in their social, school or family life, and other coping strategies you are trying are not helping, talk to your family doctor, school guidance counsellor or search for mental-health supports in your community.

How can I help alleviate teen anxiety before tests?

A small amount of anxiety about performance on tests can be helpful to encourage students to study and prepare, and increase performance through adrenaline release. However, some teens need help achieving balance with managing anxiety on tests so they don’t become extremely distressed and thus not perform to their ability. Anxiety can be overwhelming at times for teens with schoolwork, and can lead to thinking and worrying about everything at once such as a test tomorrow, essay next week, project next month and exams at the end of the semester. Anxious youth have difficulty prioritizing and focusing on the task at hand due to thinking about everything at once and feeling everything is urgent and due tomorrow (and worth 100 per cent of their mark!), and this can lead to avoiding work. Helping students with setting up time lines, prioritizing work and scheduling tasks can help decrease anxiety and increase work initiation and completion.

From a teacher’s point of view, frequent, small, regular tests that are a very small percentage of the teen’s mark can help in making test taking less stressful and increase confidence for exams. Making sure students know what is going to be covered on a test, and reviewing the material beforehand, is helpful for decreasing anxiety. Teaching students about stress and strategies to manage test stress (preparing in advance, getting a good night’s sleep, eating breakfast, doing something physically active, thinking positively “I have studied” “I know this stuff”) can help, and reviewing relaxation strategies such as deep breathing before starting the test, can help the brain and body to relax and perform better.

The Globe and Mail
Published Thursday, Feb. 21 2013